The flow24h35Are full body MRIs worth it?
After an attack of prostate cancer, Don Garnier wanted to take a more proactive approach to his health. That’s why he went out of his way to pay $2,500 for a full-body MRI at a private clinic in Vancouver called Prenuvo.
“We now live in a world where getting medical care can be a bit of a challenge, so the more on top of your health you are, the better,” he said. The flow.
Garnier said the results of the analysis took five days to arrive and were unremarkable, which was good news. He said clinical nurses reviewed the results with him in detail.
He believes it was worth it for his peace of mind – and many people share this view.
Although full-body MRIs – using magnetic resonance imaging technology to scan your body for anything abnormal – are not newthey have recently gained popularity thanks to the support of celebrities like Kim Kardashian.
But as more private clinics begin offering them, some doctors are advising their patients to think twice before slipping into the machine.
“I think the general view of the medical establishment is that, you know, these things don’t have a lot of evidence and we should be very careful about advising people to get something like that,” said Dr. Dhruv Khullar, physician. and a New York writer, said The flowIt’s Matt Galloway.
Peace of mind or anxiety?
Khullar says companies offering full-body MRIs “promise the feeling that you are in charge of your health care” and peace of mind.
But he says that story is only partially true and that the exams can also be a problem for patients.
“People can feel anxiety,” he said. “They may receive false positive test results. They may be diagnosed with conditions that might never harm them.”
Khullar personally understands these anxieties as he has undergone a full-body MRI – and he said his own experience speaks to some of the challenges they face.
Everything about his results seemed correct, he said. But there was a centimeter-long lesion in his prostate, and it wasn’t clear whether it was cancerous.
“These are sometimes called incidentalomas,” he said. “These are kinds of asymptomatic anomalies that are discovered incidentally and which generate more questions than answers.”
Khullar needs a follow-up blood test, and he will have to have a dedicated follow-up MRI of the prostate to get a clearer answer.
“I’m still going to have to have a follow-up MRI dedicated to the prostate to really understand what’s going on there,” he added.
Khullar said his feeling is that the injury will not harm him. But now that he knows, he feels like he’s had to change his identity from someone healthy to someone patient.
“Now, instead of assuming I’m healthy…I know there is something inside me and I need continued testing to prove to myself and those close to me that I am, in fact, in good health,” he said.
Turtles, birds and rabbits
According to Khullar, it’s important that screening tests be targeted to certain people, at certain ages and at certain times in life, “because the likelihood of finding something that you can actually intervene in and change the trajectory of your life a person in a positive way is relatively high. “.
But testing for anything in the body, or trying to, can be “a recipe for getting a huge number of false positives and potentially overdiagnosis,” he said.
You do the screening, you find the problem and you can intervene in a way that would be helpful-Dr. Dhruv Khullar, New York physician and writer
Take cancers, which whole-body MRIs can reveal. Khullar says cancers can be described as turtles, birds and rabbits in a barnyard, with screening and testing acting as a barrier that prevents them from escaping.
Turtles, like some prostate and thyroid cancers, move so slowly that they will never get out of the barn, “so screening doesn’t really help you,” Khullar said. “In fact, you find it and you may end up with unnecessary biopsies or other tests.”
Birds, on the other hand, are very aggressive cancers that can develop at some point, but there are currently no interventions to help patients, so the fence will not stop them from flying away.
Then there are rabbits, which suffer from certain breast and colon cancers. According to Khullar, these are the cancers that can be controlled through targeted screening.
“You do the screening, you find the problem and you can intervene in a way that would be helpful,” he said.
“So thinking about tumors in terms of turtles, birds and rabbits illustrates why screening tests may not be useful for all types of cancer and why we need to be judicious about their use.”
Pressure on public health
Some doctors also worry about the added strain false positives or benign problems could put on Canada’s health care system.
Dr. Ania Kielar, president of the Canadian Association of Radiologists, says radiology is the backbone of chemotherapy and surgery. Without a radiological diagnosis, people cannot get the treatment they need.
Yet Canada is currently experiencing a huge shortage of CT and MRI technologists – in the thousands, according to Kielar. That, coupled with a shortage of modern equipment, leads to long wait times for public health patients who need imaging, she said.
“On average in Canada, people wait up to 100 days for an MRI, even though most guidelines say that a non-urgent MRI must last less than 28 days” she told Galloway. “So we’re waiting three times as long as we should.”
According to Kielar, if companies offering full-body MRIs discover something serendipitous, “the majority of the time, these people who are healthy and are now patients end up entering our public health care system in Canada.” she declared.
“And because we have such limited resources, we don’t have the capacity right now to take care of a bolus of people who have incidental findings that are not clinically significant, but kind of need to be resolved because that they have now been found.”
In a statement to The flowAndrew Lacy, CEO of Prenuvo, rejected the claim that private clinics would take resources away from public health care and contribute to a depleted system.
“We believe our healthcare system is exhausted because late treatment of cancer and disease is horribly ineffective and leads to much worse outcomes for patients,” he said.
“We hope that the approach championed by Prenuvo will one day become part of the standard of care in a transformed healthcare system based on precision preventive medicine.”
Lack of data
Khullar doesn’t deny that some patients, like Garnier, have positive experiences with full-body MRIs. The overarching question is how many people need to be analyzed for a case like Garnier’s to be discovered.
It’s a question that has no answer at the moment, according to Khullar. This may be why no professional medical society currently recommends full-body MRIs as a preventative screening tool, nor are these exams covered by insurance.
“The reason is there’s no real evidence that they’re going to help you,” he said. “So the insurers, the government payers, are not going to cover those things.”
Currently, CEO Lacy says Prenuvo is collecting data on the effectiveness of full-body MRIs – “and because it’s “long-term data,” it takes time.”
However, the company currently relies on “14 years of clinical practice to perform these exams” and make many early diagnoses to ensure their effectiveness, he said.
Produced by Amanda Grant and Emma Posca. This story is the first installment of The Current’s new series, Well Founded, which explores the wellness industry and how to make sense of all the arguments about how to become better.